Six-month outcomes in a French cohort of patients receiving a safety planning type intervention after suicide attempt
摘要
The Safety Planning Intervention (SPI) is an intervention validated by the Stanley team, as a strategy for preventing suicidal recurrence. It allows the patient to develop a personalized emergency plan that can be used in the event of a suicidal crisis In a previous study, it was shown that, in routine post-emergency clinical settings, that the SPI was well accepted by patients and feasible for healthcare professionals. Nevertheless, limited data exist regarding the long-term follow-up. The study aimed to assess the factors associated with the likelihood of recurrence of a suicide attempt at 6 months among patients who received SPI, as well as the usefulness of this brief intervention. This was alongitudinal cohort study with a six-month follow-up, involving patients hospitalized at Bichat Hospital (Paris, France) for a suicide attempt between June 2022 and December 2023, who received a SPI, aged over 18 years, agreeing to participate in the study. Self-questionnaires were conducted to assess mood and the presence of substance use disorders. A descriptive analysis of the data was performed, factors associated with suicide recurrence was based on a dichotomized variable, and a logistic regression analysis was used to identify factors associated with recurrence. One month after inclusion, 85.4% of the patients still participating in the study remembered the SPI, and 68.8% still had their personalized SPI in their possession At six months, among the 40 patients contacted, 25.0% of of those still being followed had made another suicide attempt, and 70.0% of them had sought care at the emergency department. No factor was associated with the usefulness of the SPI. Regarding the probability of recurrence of a suicide attempt at 6 months, it appeared to decrease with increasing age (OR = 0.92, 95% CI [0.84 ; 0.99], p-value = 0.035). Being a student (OR = 5.25 95% CI [1.02 ; 26.98], p-value = 0.047)and a history of suicide attempts (OR = 9.00 95%CI [1.00 ; 80.8], p = 0.050) increased the odds of suicide reattempt at 6 months. In the multivariate analysis, a history of suicide attempt was the only factor independently associated with reattempt at 6 months (OR = 26.6 95%CI [1.28 ; 551.87], p-value = 0.034). This study supports potential importance of brief interventions in managing suicidal crises and preventing recurrence. This work makes it possible to propose new hypotheses regarding the importance of regularly revisiting suicide crisis prevention strategies throughout follow-up.